NPI | 1962443283 |
---|---|
Former Name | JOELL GRANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AK 253) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AK 12304) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2012-12-17 |